Extreme Temperature Protocol in Middlesex-London

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Clean Air Partnership Webinar March 17, 2009 Extreme Temperature Protocol in Middlesex-London Presented by Iqbal Kalsi, MBA, CPHI(C), CCEP iqbal.kalsi@mlhu.on.ca 1

History Informal monitoring, tracking and responding to extreme weather since 1999. July 2005 Middlesex-London recorded more than 10 consecutive days of extreme heat. July 13, 2005 cooling centres were established across London & Middlesex County. It was identified that a combined effort of public health, city & county managers, social services workers and emergency medical officers was needed to develop a systematic plan to provide assistance to the most vulnerable populations. Planning Principles Identify a lead agency and participating organizations Use consistent, standardized warning system activated and deactivate and the according education 2

Implement response activities targeting high-risk populations Collect and evaluate information Ongoing revision of the plan Why a Protocol? To make official the practice of issuing a Heat Alert Response and a Cold Alert Response to inform local agencies, in a coordinated manner, of the forecast of an extreme weather temperature to ensure that vulnerable persons are informed and protected. 3

Protocol Goal To reduce the health risks associated with extreme hot or cold weather, especially for those at risk (e.g. seniors, those with underlying medical conditions, homeless persons) through a coordinated, community response. General Protocol Activities - Extreme Temperature Network formed 2005, Chaired by Medical Officer of Health or (delegate). - Developed Extreme Temperature Protocol Policy for Middlesex-London Health Unit staff in 2005. - Monitor email, weather radio & website for extreme temperature alert criteria. - Spring and Fall Network membership meetings to review protocol, roles and responsibilities. - Develop and revise English and French public education resources. 4

Criteria for Initiating Alerts A Cold Alert is initiated in the following circumstances, when one or more of these criteria are met: Daily predicted low temperature of 15 degrees Celsius without wind chill; or The wind chill reaches the level at which Environment Canada issues a warning for outdoor activity for people in the Middlesex- London area; or Extreme weather conditions, such as a blizzard or ice storm. 5

Cold Alert Activities 2006 February 17 3 days 2007 January 25 1 day February 2 4 days February 14 2 days February 23 1 day March 5 2 days 2008 January 2 1 day January 30 1 day February 9 3 days February 15 2 days Extended Feb 19 3 days December 22 1 day 2009 January 13 5 days January 19 3 days January 23 4 days January 30 2 days February 3 3 days February 23 1 day March 2 2 days 6

Criteria for Initiating Alerts A Heat Alert means an oppressive air mass is forecast and the likelihood of excess weather-related mortality exceeds 65 percent. (Toronto Public Health, http://www.toronto.ca/health/heatalerts/whathappensheatalert.htm) A Heat Alert is initiated in the following circumstances, when one or more of these criteria are met: The forecast is showing a humidex advising of 40 Celsius or higher. The humidex is forecast to rise to 36 Celsius or higher, combined with an Environment Canada Smog Alert. High temperatures without a humidex reading equal 38 Celsius or above. Environment Canada issues a humidex warning for outdoor activity for people in the Middlesex- London area. e1 7

Slide 14 e1 should we consider removing this one or at least listing it last on this slide? experience; 2009-03-10

Heat Alert Activities 2006 May 29 1 day July 16 2 days July 31 2 days 2007 June 26 2 days July 9 2 days August 1 3 days 2008 no alerts issued Monitoring Temperature, air quality and wind chill information is monitored by Middlesex-London Health Unit staff through the Environment Canada and Air Quality Ontario web sites. These sites post special weather statements, including information on heat, cold and smog episodes. http://weatheroffice.ec.gc.ca/canada/on_e.html http://airqualityontario.com 8

Notification Middlesex-London Health Unit staff receive daily an advance 5-day e-weather forecast from Environment Canada and a specific message when there is either Smog, Wind Chill or Humidex Advisories issued for Southern Ontario. Consultation Middlesex-London Health Unit staff consult with the local weather office to discuss Middlesex-London specific forecasts with a trained meteorologist, if necessary. 9

Decision Based on weather sources and conditions, the Medical Officer of Health (or delegate) will determine if the Middlesex-London Health Unit will issue a Heat Alert to the communities in Middlesex-London. Activation If a Heat or Cold Alert is declared by the Medical Officer of Health (or delegate), Health Unit staff send notification to the Extreme Temperature Network via email and fax. Each agency is then responsible for internal notification of its staff and for the notification of their external partnering services. 10

Communications In addition, Heat Alert and Cold Alert information will be posted to the Middlesex-London Health Unit s website at www.healthunit.com Media Notification The Middlesex-London Health Unit sends notification of each Alert to all media outlets by fax in Middlesex-London (both print and broadcast). 11

Public Education Information can be obtained by calling the Middlesex-London Health Unit at 519-663- 5317 Ext 2300 and visiting the website at www.healthunit.com Agencies can include information in their newsletters and post on their bulletin boards and on their websites and be prepared to answer questions. Education via the media (articles/fact sheets submitted). Supplementary education may be delivered when a Heat Alert is called and when the media interview staff. 12

Heat Alert protracted? When a Heat Alert lasts longer than 3 days, it becomes an Event. Middlesex-London Health Unit activates Emergency Operations Centre to help coordinate the County and City s Hot Weather response during a prolonged heat emergency. Provide Corporate Communications at both the County and City with an electronic copies of all media releases and information fact sheets issued. Staff of Environmental Health and Chronic Disease Services operate an telephone information line to answer questions regarding temperature related issues and refer concerned citizens calls as appropriate. Termination Once the decision has been made that the extreme hot weather or extreme cold weather is no longer a health threat the Medical Officer of Health (or delegate) terminates the Heat Alert or Cold Alert by notifying the Network, participating agencies and the media. Individual agencies are be responsible for notifying their staff and partnering services that the Alert has been terminated. 13

Agency Roles & Responsibilities Currently have 37 Network member agencies and organizations. It is the responsibility of the Extreme Temperature Network membership to ensure that the Protocol is reviewed and updated on bi-annual basis. Successes shared Protocol and consulted with many Health Units and other agencies in Ontario. MLHU staff resource packages updated and distributed each year. Participate in a Childcare Provider workshop in October 2006 reaching 200+ workers. profiled and recognized the good work done by community partners and volunteers during times when Extreme Temperature Alerts are in effect. added to media messaging during heat alerts that donations of sunscreen and sun hats would be of benefit to clients of shelters. 14

Challenges Bringing 37 Network members together twice per year. Collecting data from each organization. School Boards not currently participating as members of the Network. No formal evaluation to date. Future continue to partner in consultation and collaboration with Network membership. meeting with Research, Education, Evaluation & Development (REED) Services in March to develop an evaluation tool and process Spring Network meeting will include a membership survey to measure our progress after 3 years, how we can work more collaboratively, and discuss future directions. next steps? 15

Fact Sheet Resources English and French versions of: Heat Alert Guidelines - general public, child cares & schools Managing Heat-Related Illness Understanding the UV Index Air Quality Index & You 16